Uveal effusion syndrome in 104 eyes: Response to corticosteroids - The 2017 Axel C. Hansen lecture

被引:29
作者
Shields, Carol L. [1 ]
Roelofs, Kelsey [1 ]
Di Nicola, Maura [1 ]
Sioufi, Kareem [1 ]
Mashayekhi, Arman [1 ]
Shields, Jerry A. [1 ]
机构
[1] Thomas Jefferson Univ, Wills Eye Hosp, Ocular Oncol Serv, Philadelphia, PA 19107 USA
关键词
Choroid; corticosteroids; detachment; effusion; melanoma; pseudomelanoma; uvea; uveal effusion syndrome; CLINICAL-FEATURES; SURGICAL-MANAGEMENT; CHOROIDAL MELANOMA; CILIARY BODY; PSEUDOMELANOMAS; DIFFUSION;
D O I
10.4103/ijo.IJO_752_17
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
The purpose of the study was to investigate the corticosteroids for uveal effusion syndrome (UES). Methods: Retrospective series of 104 eyes with UES treated with oral corticosteroids (OCS), periocular corticosteroids (PCS), topical corticosteroids (TCS), or observation (OBS). Main outcome measure was UES resolution. Results: Of 104 eyes, treatment included OCS (n = 27), PCS (n = 12), TCS (n = 11), and OBS (n = 54). A comparison of the four groups (OCS vs. PCS vs. TCS vs. OBS) revealed differences in those managed with OCS versus OBS as younger (66 vs. 72 years, P = 0.049), PCS versus OBS as male (100% vs. 54%, P = 0.002), PCS versus OBS with decreased visual acuity (VA)/visual field (91% vs. 51%, P = 0.018), and OBS versus OCS as asymptomatic (28% vs. 0%, P = 0.001). Of the 59 with follow-up information, management included OCS (n = 21), PCS (n = 12), TCS (n = 6), and OBS (n = 20). There were differences in initial VA < 20/400 in PCS versus OBS (42% vs. 5%, P = 0.018), effusion thickness in TCS versus OCS (7 vs. 3 mm, P = 0.004), and serous retinal detachment in PCS versus OBS (100% vs. 30%, P < 0.001) and PCS versus OCS (100% vs. 57%, P = 0.012). Regarding outcomes, VA showed less worsening in OCS versus OBS (0% vs. 30%, P = 0.008) and OCS versus PCS (0% vs. 33%, P = 0.012). There was no difference in rate of effusion resolution or effusion recurrence. Overall, using combination of corticosteroid therapies, effusion resolution was achieved in 56/59 (95%) cases and the need for surgical management with scleral windows was necessary in only 3/59 (5%) cases. Complications included cataract (n = 9) and no instance of steroid-induced glaucoma. Conclusion: Management of UES is complex and depends on disease severity. Using various corticosteroid delivery routes, UES control was achieved in 95%, and scleral window surgery was required in only 5%. A trial of corticosteroids can benefit patients with UES.
引用
收藏
页码:1093 / 1104
页数:12
相关论文
共 28 条
  • [1] Bausili Maria M, 2017, Retin Cases Brief Rep, V11, P191, DOI 10.1097/ICB.0000000000000357
  • [2] BROCKHURST RJ, 1980, ARCH OPHTHALMOL-CHIC, V98, P1987
  • [3] THE SURGICAL-MANAGEMENT OF UVEAL EFFUSION SYNDROME
    CASSWELL, AG
    GREGOR, ZJ
    BIRD, AC
    [J]. EYE-TRANSACTIONS OF THE OPHTHALMOLOGICAL SOCIETIES OF THE UNITED KINGDOM, 1987, 1 : 115 - 119
  • [4] Uveal Effusion Syndrome
    Elagouz, Mohammed
    Stanescu-Segall, Dinu
    Jackson, Timothy L.
    [J]. SURVEY OF OPHTHALMOLOGY, 2010, 55 (02) : 134 - 145
  • [5] Sclerotomy in uveal effusion syndrome
    Faulborn, J
    Kölli, H
    [J]. RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES, 1999, 19 (06): : 504 - 507
  • [6] THE UVEAL EFFUSION SYNDROME AND TRANSSCLERAL FLOW
    FORRESTER, JV
    LEE, WR
    KERR, PR
    DUA, HS
    [J]. EYE, 1990, 4 : 354 - 365
  • [7] UVEAL EFFUSION SYNDROME - A NEW HYPOTHESIS CONCERNING PATHOGENESIS AND TECHNIQUE OF SURGICAL-TREATMENT
    GASS, JDM
    [J]. RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES, 1983, 3 (03): : 159 - 163
  • [8] GASS JDM, 1982, OPHTHALMOLOGY, V89, P1018
  • [9] A MODIFIED ULTRASOUND-GUIDED SURGICAL TECHNIQUE FOR THE MANAGEMENT OF THE UVEAL EFFUSION SYNDROME IN PATIENTS WITH NORMAL AXIAL LENGTH AND SCLERAL THICKNESS
    Ghazi, Nicola G.
    Richards, Charles P.
    Abazari, Azin
    [J]. RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES, 2013, 33 (06): : 1211 - 1219
  • [10] Massive choroidal effusion and painful secondary glaucoma from underlying uveal melanoma
    Iturralde, Juan C.
    Bianciotto, Carlos
    Lally, Sara E.
    Krasnow, Michael
    Shields, Carol L.
    [J]. GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, 2012, 250 (04) : 627 - 630